Provider Demographics
NPI:1851899801
Name:ATC MEDICAL TRANSPORT CORP
Entity Type:Organization
Organization Name:ATC MEDICAL TRANSPORT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IVANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-304-5122
Mailing Address - Street 1:1250 SW 27TH AVE STE 507
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4751
Mailing Address - Country:US
Mailing Address - Phone:305-799-8094
Mailing Address - Fax:305-638-8003
Practice Address - Street 1:1250 SW 27TH AVE STE 507
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4751
Practice Address - Country:US
Practice Address - Phone:305-799-8094
Practice Address - Fax:305-638-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid